From the Guidelines
Xyzal (levocetirizine) is the preferred choice over cetirizine for patients with allergic rhinitis and concomitant asthma, as it has been shown to decrease both symptoms and improve quality of life 1. When comparing Xyzal and cetirizine, it's essential to consider their efficacy in relieving upper and lower respiratory tract symptoms.
- Xyzal has been found to be effective in reducing symptoms associated with asthma, similar to montelukast 1.
- Cetirizine, on the other hand, has been shown to relieve upper and lower respiratory tract symptoms in patients with allergic rhinitis and concomitant asthma, but its effects on asthma symptoms are modest 1. Key differences between the two medications include:
- Xyzal is the more potent active isomer of cetirizine, which may result in faster relief and fewer side effects for some patients.
- The dosage of Xyzal is typically lower (5mg) compared to cetirizine (10mg).
- Cetirizine is generally less expensive and available as a generic medication and over-the-counter. It's crucial to weigh these factors and consider individual patient responses, cost, and insurance coverage when deciding between Xyzal and cetirizine.
- Patients with liver or kidney problems may require dosage adjustments, and healthcare providers should be consulted to determine the best course of treatment.
- Ultimately, the choice between Xyzal and cetirizine should prioritize the patient's quality of life, morbidity, and mortality, with Xyzal being the preferred option based on the available evidence 1.
From the FDA Drug Label
PRINCIPAL DISPLAY PANEL Levocetirizine Dihydrochloride Tablets USP 5 mg-35's Container carton Compare to XYZAL® Allergy 24HR Active Ingredient* Allergy Relief ACTIVE INGREDIENT(S) Levocetirizine dihydrochloride USP 5 mg
Levocetirizine is the active ingredient in XYZAL.
- Cetirizine is related to levocetirizine, as an allergic reaction to cetirizine is a contraindication for levocetirizine 2.
- Levocetirizine and cetirizine are likely to have similar antihistamine effects, but the FDA drug label does not provide a direct comparison of xyzal and cetirizine. The FDA drug label for levocetirizine does not provide sufficient information to determine the differences between xyzal and cetirizine 2, 2, 2.
From the Research
Comparison of Xyzal and Cetirizine
- Xyzal, also known as levocetirizine, is a selective, potent, oral histamine H(1) receptor antagonist used for the symptomatic treatment of allergic rhinitis and chronic idiopathic urticaria 3.
- Cetirizine is another antihistamine that has been compared to levocetirizine in terms of efficacy and safety.
- A study comparing the effectiveness of modern antihistamines, including levocetirizine and cetirizine, found that monotherapy with levocetirizine was significantly more effective in lowering the Total Symptom Score and the Total Nasal Symptom Score than other antihistamines, including cetirizine 4.
- Another study found that levocetirizine was significantly more effective than cetirizine in reducing overall symptoms of chronic idiopathic urticaria 5.
- However, a 12-week, open-label, crossover study found that patients reported significantly longer symptom relief with cetirizine than levocetirizine 5.
Efficacy and Safety
- Levocetirizine has been shown to be effective in reducing symptoms of allergic rhinitis and improving health-related quality of life in US adults with seasonal allergic rhinitis 6.
- A meta-analysis comparing the effectiveness of levocetirizine and loratadine found that levocetirizine was significantly more effective in improving the total symptom score 7.
- The safety profile of levocetirizine is generally acceptable, with common adverse events including headache, pharyngitis, and somnolence 5, 6.
Comparison to Other Antihistamines
- Levocetirizine has been compared to other antihistamines, including desloratadine, loratadine, and fexofenadine, and has been found to be more effective in some studies 3, 4, 7.
- However, the effectiveness of levocetirizine compared to other antihistamines may depend on the specific population being studied and the symptoms being treated.